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E. *N PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS:Drop off hard copy paper application&plans to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> WASHINGTON CONTACT INFORMATION:(P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 9!® s; Fileattwif W&7 PARCEL#: ,So 5 I g0O30G'( Oh <br /> CITY e'V f STATE IAJM L 43 P 9 zo <br /> SUITEIUNIT#: I 0 2... ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential): V (be, —Fr'(he, 1r�'c.. s <br /> CONTACT INFORMATION <br /> OWNER NAME: `3 r it 9e.rl -Duce---, <br /> OWNER MAILING ADDRESS: sir Cl (Q se & Xeil- Ha(1 Ore'"/ S v i le. I D2- G�{j <br /> Cn 1? V( ..tF4...if. STATE ( J ZIP O 2.o R <br /> 'OWNER PHONE: 'fd(a,- 570, 11 7 t OWNER EMAIL: 1?er5er) 0 bu c K-.0 q P-a{/ i 6,01 <br /> CONTRACTOR CONTACT NAME:1Ia v et,. Po IA..an 9 c1 phut f Von) ✓ <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):Si! },(,A*kg 174 CITY OFEVERETT BUSINESS LICENSE#(REQUIRED): 0 2'��' <br /> CONTRACTOR ADDRESS: STREET , ©5j ay-, f' -:0-f?,t' Hatt(,f boa/ , S S tn-fr I cf/f c <br /> cnv £v�er� STATE VNJ ZP 618208 <br /> CONTRACTORPHONE:4'(2.Jc— -, _ 023L CONTRACTOREMAIL:"I1- owee QS' (�hctrc to—eyerf t,("v- <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 9-9_5.-- 9 5 i -- 0 23 43 <br /> ( ' `a vec D o Ll a ll Fit p ti a( v o i] CONTACT EMAIL: G (a i cilia r , t--P treT,� : ram <br /> SIGN PERMIT INFORMATION <br /> VALUATION OF WORK:$ i/(P i1 50r o0 ASSOCIATED PERMIT#(if applicable): n I('cc) <br /> (Valuation shall include the prevailing fair market value of all labor.matetiais,and equipment needed to complete the work,whether actually paid.{� i or not.) ,� <br /> DESCRIPTION OF WORK: • <br /> �6 sue. 0 Q oc cyc...b f lief- <br /> -80,:e <br /> s,0 <br /> '' non l et,- -i t fxs rt rr c/ . 3 <br /> g.. .,i hs ki cal L 3 X7 Xc Q .e (..' <br /> �iit Sur vFR 1 <br /> SIGN DIMENSIONS: N Vic s,T <br /> // 3 J'�' <br /> Sign 1: Width: 1 Height '„ Square Feet: tip 5-r <br /> Sign 2: Width: 9 11 I/ Height -7 !f Square Feet LI t 5 SF <br /> Sign 3: Width: Height Square Feet <br /> (SIGN TYPE&QUANTITY: l'1412, ning/Canopy-Qty: I OWindow-Qty: ❑Electronic Changing Message-Qty: <br /> ❑Projecting-Qty: ❑Freestanding-Qty: -Type(monument,etc.): <br /> kiiie2 5twn.4I <br /> SIGN LIGHTING: Non-Ruminated 9111uminated-Type(backlit cabinet,etc.): 1 f to rn Al l L-V -*requires a separate electrical permit <br /> PLAN REVIEW REQUIREMENTS:Submit 2 hard copies of sign plans with permit application to Permit Intake Drop Box. <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct Work done pursuant to this permit must comply with <br /> current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circumstance.tam the owner,or I am authorized by the owner of this properly to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> ,-A''" PERMIT# <br /> O r/AuthorIzed Agent Signature Date (Revised 2/8/2021) 1 <br />